Postmortem Computed Tomography Study - Allergology International

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ment of Radiological Technology, Graduate School of. Health Sciences, Niigata University, Niigata, 2Present address: Department of Dermatology, Asoka Hospi ...

Allergology International. 2014;63:493-494 DOI: 10.2332! allergolint.13-LE-0655

Dear Editor

Hereditary Angioedema as the Cause of Death from Asphyxia: Postmortem Computed Tomography Study Hereditary angioedema (HAE) is an autosomal dominant disorder. Type I and type II HAE result from a deficiency of the C1-esterase inhibitor (C1-INH) due to a deletion or mutation(s) of C1INH. It may cause episodic and transient swellings of deep cutaneous and! or mucosal tissues. Symptoms usually last for a few days and may resolve spontaneously. However, airway edema may cause asphyxia and lead to death if not properly treated. 1,2 Although the asphyxia is generally due to laryngeal edema,3 “upper airway obstruction ” is more characteristic than “ laryngeal edema” to depict symptoms of HAE. Here, we report a case of HAE which led to the patient’s death and revealed fatal pharyngeal edema on postmortem CT. A 23-year-old man visited Niigata City General Hospital because of severe facial edema. He had had three similar episodes since he was 19-years-old. At this time, he did not complain of breathlessness. Laboratory examination showed reduced levels of CH50, 12 U! ml (normal 30-40 U! ml) and C4, 4 mg! dl (normal 13-34 mg!dl). Serum C1INH concentration was also decreased to 6 mg! dl (normal 10-25 mg! dl) and its enzymatic activity was